Abstract:SummaryBackground Since 75% of children with cancer will become long-term survivors, late eff ects of treatment are an ever increasing issue for patients. Paediatric oncologists generally agree that cancer survivors should be followed up for the remainder of their lives, but they might not be the most suitable health-care providers to follow up survivors into late adulthood. We designed a 3-year study to assess whether shared-care by paediatric oncologists and family doctors in the long-term follow-up of survi… Show more
“…These findings may represent different sub-groups of patients (potentially relating to risk stratification models), or they may be conflicting results from similar patient groups. As the editorial around the observational study of shared follow-up care combining primary and secondary care has emphasised, this study represents an important step in prospective evaluation of service provision and highlights the need for comparative studies in this area [13,19]. The multidisciplinary survivorship clinic was described in some detail and appears to provide a comprehensive integrated service which was valued by parents/ carers and resulted in greater uptake of services [14].…”
Section: Summary Of Resultsmentioning
confidence: 98%
“…A total of eight papers were retained despite not meeting the study design inclusion criteria with the intention of reflecting the evidence base as it currently stands (Table I) [11][12][13][14][15][16][17]. All but one of these papers were available as full publications; the remaining study was published only as an abstract reporting provisional results [11].…”
Section: Resultsmentioning
confidence: 99%
“…Participants were largely convenience samples of patients already attending/recently referred to the clinics under evaluation [13][14][15][16][17], or in two cases patients who were not currently being followed-up for various reasons [11,12]. All participants were survivors of cancer diagnosed in childhood; where this definition was explicit the diagnosis had to have been made before the age of 16 or 17 years in most cases.…”
Section: Resultsmentioning
confidence: 99%
“…All participants were survivors of cancer diagnosed in childhood; where this definition was explicit the diagnosis had to have been made before the age of 16 or 17 years in most cases. In general all childhood cancers were included in the samples with only one study excluding central nervous system tumours [13]. The sample size of survivors were small to moderate (42-245 patients) in size and response rates to both invitations to attend and return of questionnaires varied considerably.…”
Section: Resultsmentioning
confidence: 99%
“…The results Absolom et al [18] Found no differences in satisfaction between paediatric and adult clinics; key predictors of satisfaction were aspects of clinic organisation suggest this is both feasible, and acceptable, to the majority of both patients and family doctors [13].…”
“…These findings may represent different sub-groups of patients (potentially relating to risk stratification models), or they may be conflicting results from similar patient groups. As the editorial around the observational study of shared follow-up care combining primary and secondary care has emphasised, this study represents an important step in prospective evaluation of service provision and highlights the need for comparative studies in this area [13,19]. The multidisciplinary survivorship clinic was described in some detail and appears to provide a comprehensive integrated service which was valued by parents/ carers and resulted in greater uptake of services [14].…”
Section: Summary Of Resultsmentioning
confidence: 98%
“…A total of eight papers were retained despite not meeting the study design inclusion criteria with the intention of reflecting the evidence base as it currently stands (Table I) [11][12][13][14][15][16][17]. All but one of these papers were available as full publications; the remaining study was published only as an abstract reporting provisional results [11].…”
Section: Resultsmentioning
confidence: 99%
“…Participants were largely convenience samples of patients already attending/recently referred to the clinics under evaluation [13][14][15][16][17], or in two cases patients who were not currently being followed-up for various reasons [11,12]. All participants were survivors of cancer diagnosed in childhood; where this definition was explicit the diagnosis had to have been made before the age of 16 or 17 years in most cases.…”
Section: Resultsmentioning
confidence: 99%
“…All participants were survivors of cancer diagnosed in childhood; where this definition was explicit the diagnosis had to have been made before the age of 16 or 17 years in most cases. In general all childhood cancers were included in the samples with only one study excluding central nervous system tumours [13]. The sample size of survivors were small to moderate (42-245 patients) in size and response rates to both invitations to attend and return of questionnaires varied considerably.…”
Section: Resultsmentioning
confidence: 99%
“…The results Absolom et al [18] Found no differences in satisfaction between paediatric and adult clinics; key predictors of satisfaction were aspects of clinic organisation suggest this is both feasible, and acceptable, to the majority of both patients and family doctors [13].…”
The majority of children, adolescents, and young adults diagnosed with cancer will become long-term survivors with many potential years of life ahead of them. Their journey from health through diagnosis and treatment to survivorship involves multiple transitions. Transitional services that should be available throughout this journey include healthrelated education, health surveillance and screening, management of cancer-related complications, and psychosocial support relevant to their developmental needs. Survivors require lifelong care that focuses not only on the medical risks arising from their cancer therapy, but also the psychosocial, educational, and vocational implications of surviving cancer. Because many community health care providers lack familiarity with the health risks associated with childhood or adolescent/young adult cancer, survivors must have sufficient health knowledge to advocate for risk-based cancerrelated follow-up; the provision of a treatment summary and care plan at the conclusion of their cancer therapy is an important tool for facilitating this process. The availability of resources for survivors varies by geography, health care system, and survivor characteristics. Adolescents and young adults who receive their care outside of a pediatric cancer center have particularly limited access. The limitations in cancer center resources (along with survivor preference) strongly suggest that the long-term care of survivors will need to be shared between the cancer centers and primary care providers in survivors' communities. Cancer 2011;117(10 suppl):2335-
Early mortality and a high prevalence of chronic health conditions are well-recognized consequences of cancer therapy, particularly in children. The Institute of Medicine has specified the need for lifelong, risk-based health care for survivors of cancer based on the premise that appropriate screening and knowledge can mitigate risk and enhance quality of life. The institute has recommended that such programs offer surveillance, prevention, and treatment of late effects. 1 An important component of this is the recommendation that cancer treatment summaries be prepared for patients at the completion of therapy.Ford et al 2 queried adult survivors of childhood cancer diagnosed between 1970 and 1986 at 10 institutions with robust survivorship programs about the use of cancer-directed health care in the prior 2 years and the intention to use such care in the next 2 years. Participating patients were older at evaluation, were more educated, had a greater representation of females and non-Hispanic whites, and were more likely to have health insurance than nonparticipants. Because only 975 of 1600 (60.6%) opted to participate in the survey, the results could have been affected by the limited cohort. Bias in such a cohort would be expected to result in more users of medical services than nonusers. Despite this, nearly three-quarters of the respondents had not had a cancer-related health care visit in the preceding 2 years, and only 41% claimed to be planning such a visit in the next 2 years. An earlier study from the Children's Cancer Survivor Study (CCSS) showed that only 31.5% of patients who participated in the CCSS reported survivor-focused care. 3 Because of the importance of survivorship care, these numbers suggest a concerning lack of recognition in the population at risk of the need or potential benefit of such care. Several studies that address why patients do not participate in survivorship care, which is now defined as lifelong, risk-based health care for survivors of cancer, note the impact of the fear of recurrent disease, life responsibilities, and not perceiving a need, which is perhaps most critical. 4,5 Focus groups of survivors who recently completed therapy or had disengaged in follow-up care after an attempted transition also noted a need to support the transition process itself by considering developmental factors that affect the transition, by enhancing communication between patients and providers, and by incorporating digital health tools. 6 New programs for pediatric cancer survivors find themselves addressing critical issues of barriers to or facilitators of care when patients fail to access this care. Often, it is those in continuous care since diagnosis who use programs for cancer survivorship care. Ford et al 2 found that those having had a recent visit for care were patients who had moderate to life-threatening chronic health conditions, confidence in physicians, and a cancer treatment summary. All could be considered direct evidence of ongoing involvement in the medical system. With the evol...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.